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Faculty Departure Checklist, August 2015 p. 1 UVA FACULTY DEPARTURE CHECKLIST GENERAL INFORMATION The following is a standardized checklist for faculty departing the University, whether through resignation, retirement, or termination. Faculty members assuming a new position at the University that will result in a significant change in responsibilities may also need to complete parts of the checklist. The checklist must be completed and signed by the faculty member and their department chair in order for the faculty member to officially exit from the University. This checklist includes important information pertaining to University Human Resources, departmental logistics, and protocols for active research projects. This process is also intended to help departments and schools assist the University in complying with state and federal guidelines when closing out projects associated with sponsored research. Cover Sheet and Signature Page contains the faculty member’s basic information and forwarding address. It also indicates which of the appendices may apply to the faculty member’s duties and research. Signatures on this sheet testify that part 1, part 2, and any necessary appendices are complete. Part 1: Faculty Member Responsibilities should be provided by the designated department representative to the faculty member upon notice of their departure from the University. Some items within the document must be completed 90 days prior to departure. Departmental Responsibilities should be completed by the designated department representative to ensure all appropriate University entities are notified of the faculty member’s departure and verify that the department has acknowledged the various faculty member tasks in part 1. Appendices contain the closeout procedures and contact information for concerns specific to research, such as human subjects, animal subjects, patents, equipment and/or data transfer, hazardous materials etc. Completion of an appendix is required only if it is applicable to the work of the individual faculty member. Departments may add their own specific appendices tailored to their needs as appropriate. DATES Resignation Members of the teaching faculty who do not intend to return to the University for the upcoming academic year are expected to indicate their intention in writing to their dean or department chair as soon as possible, generally between October 1 st through May 1 st , but no later than May 15 th of the academic year in which he or she intends to resign. Retirement A faculty member with teaching responsibilities who wishes to retire should inform the department chair, dean and the vice president and provost in writing by March 1 of the year in which retirement is planned. In the event that a faculty member departs the University unexpectedly, is deceased or otherwise is not able to carry out their responsibilities, department personnel should immediately complete both part 1 and 2, as possible.

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Page 1: UVA FACULTY DEPARTURE CHECKLIST · 2019-06-25 · FacultyDeparture(Checklist,(August(2015(((p.(1(UVAFACULTYDEPARTURECHECKLIST GENERAL!INFORMATION! The!following!is!astandardized!checklist!forfaculty!departing!the

Faculty  Departure  Checklist,  August  2015      p.  1  

UVA  FACULTY  DEPARTURE  CHECKLIST  GENERAL  INFORMATION  

The  following  is  a  standardized  checklist  for  faculty  departing  the  University,  whether  through  resignation,  retirement,  or  termination.  Faculty  members  assuming  a  new  position  at  the  University  that  will  result  in  a  significant  change  in  responsibilities  may  also  need  to  complete  parts  of  the  checklist.  The  checklist  must  be  completed  and  signed  by  the  faculty  member  and  their  department  chair  in  order  for  the  faculty  member  to  officially  exit  from  the  University.    

This  checklist  includes  important  information  pertaining  to  University  Human  Resources,  departmental  logistics,  and  protocols  for  active  research  projects.  This  process  is  also  intended  to  help  departments  and  schools  assist  the  University  in  complying  with  state  and  federal  guidelines  when  closing  out  projects  associated  with  sponsored  research.  

Cover  Sheet  and  Signature  Page  contains  the  faculty  member’s  basic  information  and  forwarding  address.  It  also  indicates  which  of  the  appendices  may  apply  to  the  faculty  member’s  duties  and  research.  Signatures  on  this  sheet  testify  that  part  1,  part  2,  and  any  necessary  appendices  are  complete.  

Part  1:  Faculty  Member  Responsibilities  should  be  provided  by  the  designated  department  representative  to  the  faculty  member  upon  notice  of  their  departure  from  the  University.  Some  items  within  the  document  must  be  completed  90  days  prior  to  departure.  

Departmental  Responsibilities  should  be  completed  by  the  designated  department  representative  to  ensure  all  appropriate  University  entities  are  notified  of  the  faculty  member’s  departure  and  verify  that  the  department  has  acknowledged  the  various  faculty  member  tasks  in  part  1.    

Appendices  contain  the  close-­‐out  procedures  and  contact  information  for  concerns  specific  to  research,  such  as  human  subjects,  animal  subjects,  patents,  equipment  and/or  data  transfer,  hazardous  materials  etc.  Completion  of  an  appendix  is  required  only  if  it  is  applicable  to  the  work  of  the  individual  faculty  member.  Departments  may  add  their  own  specific  appendices  tailored  to  their  needs  as  appropriate.  

DATESResignation  Members  of  the  teaching  faculty  who  do  not  intend  to  return  to  the  University  for  the  upcoming  academic  year  are  expected  to  indicate  their  intention  in  writing  to  their  dean  or  department  chair  as  soon  as  possible,  generally  between  October  1st  through  May  1st,  but  no  later  than  May  15th  of  the  academic  year  in  which  he  or  she  intends  to  resign.  

Retirement  A  faculty  member  with  teaching  responsibilities  who  wishes  to  retire  should  inform  the  department  chair,  deanand  the  vice  president  and  provost  in  writing  by  March  1  of  the  year  in  which  retirement  is  planned.  

 

In  the  event  that  a  faculty  member  departs  the  University  unexpectedly,  is  deceased  or  otherwise  is  not  able  to  carry  out  their  responsibilities,  department  personnel  should  immediately  complete  both  part  1  and  2,  as  possible.  

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Faculty  Departure  Checklist,  August  2015      p.  2  

RELATED  INFORMATION  KLIST

UNIVERSITY  POLICIES  

HRM-­‐004:  Faculty  Resignation  and  Retirement  Notice    

PROV-­‐003:  Part-­‐Time  Employment  of  Retired  Members  of  the  Faculty  

PROV-­‐018:  Emeritus  Faculty  

HRM-­‐005:  Appointment  of  Unpaid  Faculty  

HUMAN  RESOURCES  LINKS  

Virginia  Retirement  System  (VRS)  Pre-­‐Retirement  Guide  

Optional  Retirement  Plan  (ORP)  Pre-­‐Retirement  Guide    

Medical  Center  Retirement  Plan  (MCRP)  Pre-­‐Retirement  Guide  

Retiree  Medical  

Prescription  Drug  Program  

Perks  for  Retirees  

How  to  Update  Beneficiaries  

OTHER  

Va.  Code  51.1-­‐124.3.  Definitions  pertaining  to  retirement  

Office  of  Sponsored  Programs,  Procedure  8.8:  Request  for  an  Individual  Not  Meeting  Policy  Criteria  to  Serve  as  a  Principal  Investigator  

Retired  Faculty  Association  of  the  University  of  Virginia  

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Faculty  Departure  Checklist,  August  2015      p.  3  

COVER  SHEET  The  following  checklist  must  be  completed  by  faculty  members  who  are  separating  employment  with  the  University  through  resignation,  retirement,  or  termination.  Faculty  members  assuming  a  new  position  at  the  University  that  will  result  in  a  significant  change  in  responsibilities  may  also  need  to  complete  parts  of  the  checklist.  Department  heads  should  retain  a  copy  of  the  completed  form  in  the  faculty  member’s  personnel  file.  

Faculty  Member  Full  Name:  

Faculty  Member  Title:    

Faculty  Member  Department:    

Department  Chair:  

Faculty  Member  Computing  ID:  

Date  of  and  Reason  for  Planned  Departure  (Resignation,  Retirement,  Termination,  or  New  Position  at  UVA):  

Forwarding  Address:  

Non-­‐UVA  Email:  

Will  your  bank  account  be  available  for  the  last  payroll  deposit?  

¨    YES,  please  deposit  in  current  account.    ¨      NO,  but  I  have  notified  University  Human  Resources  of  a  new  account  number  for  the  deposit.  

Supplementary  Checklists  in  Appendices   Include?  

A. Do  you  serve  as  a  Primary  Investigator  (PI)  on  a  grant/contract?

B. Do  you  maintain  a  research  lab  or  work  with  hazardous  materials?

C. Do  you  conduct  human  subject  research?

D. Do  you  conduct  animal  research?

E. Do  you  intend  to  transfer  equipment,  data,  or  records?

F. Have  you  disclosed  inventions  to  the  Licensing and Ventures Group  or  do  you  have  pending/issued  patents?

G. Are  you  involved  with  patient  care?

H. Are  you  identified  on  a  Technology  Control  Plan  or  participating  in  an  export  controlled  project  or  activity?

Signatures:  

Faculty  Member  Name   Signature                Date  

Department  Chair  Name   Signature                Date  

If  moving  to  a  foreign  country   there  may  be  export  control  issues.See Appendix H.  

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Faculty  Departure  Checklist,  August  2015      p.  4  

PART  1:  FACULTY  MEMBER  RESPONSIBILITIES

60-­‐90  Days  from  Departure  Date   Done   N/A  

Submit  resignation  or  retirement  letter  to  the  appropriate  dean  at  least  60  days  prior  to  last  day.  

Notify  any  committees  or  boards  on  which  you  serve.  

If  retiring,  discuss  your  eligibility  for  emeritus  statusyour  school’s  human  resources  representative.  

 and  faculty  retirement  dinner  attendance  with  

Contact  Human  Resources  Service  Center  with  any  questions  related  to  continuation  of  health  coverage  under  COBRA,  conversion  or  continuation  of  life  insurance,  and  distribution  of  retirementcontributions.  

 

Submit  information  to  department  chair  regarding  changes  in  status  of  your  graduate  student  advisees.  Are  your  students  transferring  to  other  institutions  or  finding  a  new  mentor?  If  retiring,  will  you  continue  to  chair  or  serve  on  any  dissertation  committees?  

If  any  of  your  students  are  staying  to  finish  a  degree  at  UVA  and  are  supported  by  a  stipend,  identify  the  source(s)  of  funding  for  the  remainder  of  their  course  of  study,  the  mentor  of  record,  the  lab  spacein  which  the  work  is  to  be  done  (if  applicable),  equipment  to  be  used,  and  a  budget  for  any  needed  supplies.  Discuss  details  with  department  chair.  

 

Notify  the  Officeappendix  A)  

 of  Sponsored  Programs  (OSP)  with  any  requests  for  relinquishing  awards  (see  

Notify  the  Fixedappendix  E)  

 Assets  Accounting  Group  if  any  assets  will  be  transferred  to  another  institution  (see  

If  moving  to  another  institution,  contactsensitive  information  or  equipment.  

 your  new  institution  regarding  transfer  procedures  for  

Contact  your  department’s  local  support  partner  (LSP)  for  guidance  and  assistance  in  University-­‐licensed  software  applications  and/or  records  that  are  University  property  from  any  computers  being  transferred  to  a  new  institution.  

deleting  

If  you  have  a  managed  conflict  of  interest,  notify  the  Conflict  of  Interests  Committee  of  your  departure.  

Notify  the  relevant  committee(s)  if  you  are  part  of  a  pending  inquiry  or  investigation.  

Do  youannual  support  and  how  long  will  it  continue?  Discuss  details  with  department  chair.  

 currently  provide  salary  support  or  startup  funding  to  other  employees?  If  so,  how  much  

Do  youdetails  with  department  chair.  

 direct  a  center?  If  so,  will  your  position  be  replaced  or  will  the  center  be  dissolved?  Discuss  

What  liabilities  and  financial  obligations  will  remain  after  your  departure  for  which  you  will  continuebe  responsible?  How  will  payment  be  made?  (See  also  Appendix  C  for  clinical  research  records.)  

 to  

If  you  are  leaving  for  another  institution  or  accepting  a  new  position  at  UVA,  providedepartment  with  contact  information  for  your  new  department  administrator.    

 current  

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Faculty  Departure  Checklist,  August  2015      p.  5  

15  Days  from  Departure  Date   Done   N/A  Make  arrangements  for  the  disposition  of  mail  received  by  the  department  after  departure.  

Settle  any  cash  advances,  petty  cash  accounts,  pending  reimbursements,  parking  or  library  fines,  or  any  other  unsettled  accounts  at  the  University.  

If  a  supervisor,  insure  that  budgetary  records,  documents  related  to  performance  evaluations  that  are  not  in  Lead@,  letters  or  emails  containing  resource  commitments,  and  unit  strategic  plans  are  labeled  and  organized  in  hard  copy  files  for  the  supervisory  successor.  

If  a  supervisor,  verify  that  all  evaluations,  correspondence,  etc.,  have  been  completed.

If  you  are  currently  teaching,  verify  that  all  grades  have  been  submitted.  All  graded  student  work  must  be  retained  for  one  year,  returned  to  the  student,  shredded,  or  deleted.  Make  arrangements  with  department  to  handle  retention  or  destruction  of  hard  copies  of  student  work,  as  needed.  Refer  to  the  policy  on  Grading  Practices:  https://policy.itc.virginia.edu/policy/policydisplay?id=PROV-­‐005  

Use  a  secure  data  deletion  program  to  electronically  delete  all  graded  student  work  in  electronic  form  that  is  older  than  one  semester.  Refer  to  the  policy  on  Grading  Practices  and  seek  assistance  from  department  LSP  if  needed:  https://policy.itc.virginia.edu/policy/policydisplay?id=PROV-­‐005

Consult  with  department  LSP  and  the  Information  Security,  Policy,  and  Records  Office  (ISPRO)  for  retention  and/or  disposition  of  email,  home  directory  files,  websites,  and  any  other  electronic  materials.  Retirees  may  retain  their  computing  ID  by  sending  request  to  accounts-­‐[email protected].      

Contact  University  Human  Resources  to  determine  if  you  need  to  complete  a  Virginia  Conflict  of  Interest  Statement.    

Within  1-­‐2  Days  from  Departure  Date   Done   N/A  Remove  personal  items  from  offices  or  lockers.  

Return  all  keys  to  department.  

If  leaving  UVA,  return  UVA  ID  to  ID  Card  Office:  http://www.virginia.edu/idoffice/.  Retirees  can  request  a  new  identification  card.  

If  leaving  UVA,  return  all  University-­‐owned  equipment  to  department  LSP  or  ITS,  including  UVA  identity  token,  computers,  mobile  devices,  pagers,  long  distance  calling  cards,  copy  cards,  and  storage  media.  If  transferring  to  a  new  position  within  UVA,  determine  necessary  returns/transfers  with  department  LSPs  in  current  and  new  departments.    

If  in  possession  of  a  university  parking  pass,  return  your  pass  to  Parking  &  Transportation  

Return  University  credit  cards  and  travel  cards  to  department.  

Return  University  portable  computer/mobile  devices/pager/long  distance  calling  card/copy  card  to  department  or  to  ITS.  

Migrate  or  delete  all  electronic  files  containing  University  data  from  personally  owned  computers,  mobile  devices,  cloud  storage,  and  storage  media  (e.g.  flash  drives,  etc.)  

Uninstall  all  University  licensed  software  from  personally  owned  computers  and  mobile  devices.  

Post-­‐Departure   Done   N/A  

Notify  UHR  Payroll  Office  of  any  change  of  address  during  the  year  so  that  a  W-­‐2  tax  statement  can  be  sent  in  January.  

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Faculty  Departure  Checklist,  August  2015      p.  6  

PART  2:  DEPARTMENTAL  RESPONSIBILITIES  

At  First  Notice  of  Departure   Date  Complete  

Give  facultyappendices  and  any  checkout  procedures  specific  to  your  individual  department.  

 member  part  1  of  this  checklist,  Faculty  Member  Responsibilities,  as  well  as  any  relevant  

Fax  notice  of  resignation  or  retirement  letter  to  the  office  of  the  dean  or  department  head  and  University  Human  Resources  immediately  upon  receipt.  Track  resignation  and  retirements  for  the  purposes  of  reporting  them  to  the  Board  of  Visitors.  Email  the  faculty  actions  specialist  in  the  Provost’s  Office  directly  if  a  retiring  faculty  member  will  be  nominated  for  emeritus  status.  

Notify  the  following  offices  (where  applicable)  of  faculty  member’s  pending  departure  or  change  in  position.  Provide  them  with  faculty  name  and  departure  date.  These  offices  correspond  with  the  additionalappendices  to  this  form.  Appendix  A:  Grants  and  Contracts/Office  of  Sponsored  Programs  (OSP)  Appendix  B:  Research  Labs  and  Hazardous  Materials/Office  of  Environmental  Health  and  Safety  (EHS)  Appendix  C:  Human  Subjects  Research/Institutional  Review  Board  (IRB)  Appendix  D:  Animal  Research/Institutional  Animal  Care  and  Use  Committee  (IACUC)  Appendix  E:  Transfer  of  Equipment,  Data,  Records  or  Other/  Vice  President  for  Research  (VPR)  Appendix  F:  Intellectual  Property/Licensing  &  Ventures  Group  (LVG)  Appendix  G:  Patient  Care/Piedmont  Liability  Trust  and  UVA  Health  Information  Services  Appendix  H:  Exports  and  Technology  Control  Plans/Office  of  Export  Controls  

 

Enter  faculty  member  termination  date  in  University’s  Integrated  System  and  enter  appropriate  reason  code.  

Recommend  to  faculty  member  that  he/she  meet  with  UVA  HR  Benefits  Office.  

Enter  faculty  member’s  new  address  with  UHR  so  that  U.S.  mail  can  be  forwarded.  

Process  any  non-­‐reimbursed  travel  expenses  through  the  department  prior  to  termination  date.  

60-­‐90  Days  from  Departure  Date   Done   N/A  

For  faculty  members  in  non-­‐immigrant  visa  status  (H-­‐1B,  TN,  E-­‐3,  O-­‐1):  Notify  University  Human  Resources  Compliance  and  Immigration  Services  (HRCIS)  of  all  departing  faculty,  whether  resigning  or  being  dismissed,  so  HRCIS  can  withdraw  visa  sponsorship  and  work  authorization.  Under  US  immigration  laws,  if  an  H-­‐1B  or  O-­‐1  employee  is  terminated  from  employment  by  the  department  before  the  ending  validity  date,  the  department  is  liable  for  and  must  offer  the  reasonable  cost  of  return  transportation  of  the  foreign  faculty  member  to  his/her  country  abroad.  Written  proof  of  the  offer  must  be  retained  by  the  department  and  communicated  to  HRCIS.  If  the  faculty  member  is  not  departing  the  USA,  the  department  is  not  required  to  pay  the  reasonable  costs  of  transportation.  Contact  HRCIS  at  [email protected].  

15  Days  from  Departure  Date   Done   N/A  Verify  that  all  equipment,  records,  and  data  that  will  be  left  at  UVA  have  been  received  and  secured.  

Confirm  removal  of  access  privileges  and  return  of  University  property.  See:  http://www.hr.virginia.edu/hr-­‐for-­‐you/university-­‐staff/university-­‐staff-­‐policies-­‐and-­‐procedures/university-­‐staff-­‐employee-­‐relations-­‐policies-­‐and-­‐procedures/access-­‐privileges/  

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Faculty  Departure  Checklist,  August  2015      p.  7  

On  Last  Day   Done   N/A  

Request  completed  part  1  of  the  faculty  departure  checklist  from  the  faculty  member.  

Verify  that  all  electronic  files  containing  University  data  have  been  removed/transferred  to  UVA  from  his/her  personally-­‐owned  computers,  hand-­‐held  devices,  and  electronic  media.  

Verify  all  University  licensed  software  from  personally  owned  computers  and  mobile  devices  has  been  uninstalled.  

Verify  return  of  University  portable  computer/mobile  devices/pager/long  distance  calling  card/copy  card  to  department  or  to  ITS.  

If  leaving  UVA,  verify  return  of  VPN  hardware/UVA  identity  key  to  department  LSP  or  ITS.  

Confirm  that  department  has  access  and  passwords  for  any  electronic  files  being  left  at  UVA.  

Verify  return  of  University  credit  cards  or  travel  cards  to  department.  

Verify  removal  of  personal  items  from  offices  or  lockers.  

Verify  return  of  all  keys  to  department.  

Verify  return  of  ID  badge  to  UVA  ID  Badge  Office.  

Post-­‐Departure   Done   N/A  

Reassign  any  direct  reports  to  a  new  supervisor  in  the  University  Integrated  System,  if  necessary.  

Deactivate  building  access  and  security  cards.  

Confirm  departure  with  University  Human  Resources  (UHR).  

Cancel  access  to  the  network,  University  Integrated  System,  etc.  within  48  hours.  

Cancel  photocopier  access  number.  

Clean  drives  for  computers  being  reassigned.  

Remove  access  to  locally-­‐maintained  computer  network(s).  

If  applicable,  change  signature  authority  for  time  cards  by  sending  a  memorandum  to  Payroll  Office  in  UHR.  

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Faculty  Departure  Checklist,  August  2015      p.  8  

APPENDIX  A:  GRANTS  AND  CONTRACTS  To  be  completed  by  a  principal  investigator  on  a  grant  or  contract.  

Because  grants  and  contracts  are  made  to  the  University  of  Virginia  and  not  to  individuals,  they  must  be  closed  out  by  the   University   before   they   are   relinquished   (transferred)   to   another   institution.   The   requirements   vary   but   generally  include  financial,  technical,  and  patent  reporting.  UVA  will  relinquish  the  award  or  contract  back  to  the  sponsor  and  the  sponsor  will  then  make  a  new  award  or  enter   into  a  contract  with  the  new  institution.  All   items  listed  below  should  be  completed  PRIOR  to  the  faculty  member’s  departure  from  UVA.  

School  Grants  Offices  Architecture     982-­‐2306  Arts  &  Sciences   924-­‐7139  Education     924-­‐3841  Engineering    Medicine    

924-­‐3756  924-­‐8426  

Nursing     924-­‐0074  

90  Days  from  Departure  Date   Date  Complete  

Alert  your  unit  administrator,  school  administrator,  and  the  Office  of  Sponsored  Programs  (OSP)  of  your  intent  to  transfer  a  grant  or  contract  to  another  institution.  

Before  Departure   Date  Complete  

Provide  contact  information  for  new  institution  to  OSP  and  provide  OSP’s  contact  information  to  new  institution.  

Complete  and  submit  final  invention  statements  to  sponsor  as  required,  see  Appendix  F.  

Ensure  that  all  required  progress  reports  and  final  reports  have  been  prepared  and  submitted.  

Request  that  your  administrator  (department  or  school,  as  appropriate)  prepare  a  relinquishing  statement  or  similar  sponsor  document.  Your  administrator  will  work  with  OSP  for  final  approval.  

Prepare  request  to  sponsor  for  the  transfer  of  any  equipment,  also  see  Appendix  E.  Ensure  that  all  original  documents  are  given  to  the  appropriate  departmental  administrator  and  inform  that  administrator  about  any  copies  of  documents  that  will  be  leaving  the  University.  

If  transferring  a  grant  or  contract,  ensure  that  your  school’s  Grants  and  Contracts  Office  and  OSP  have  a  current  copy  of  all  proposals  and  reports.  

All  other  schools,  contact  the  Office  of  Sponsored  Programs    924-­‐4270  http://www.virginia.edu/sponsoredprograms/  

Arts  &  Sciences   924-­‐7139  Education     924-­‐3841  Engineering     924-­‐3756  Medicine     924-­‐8426  Nursing     924-­‐0074  

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Faculty  Departure  Checklist,  August  2015      p.  9  

Appendix  A:  Grants  and  Contracts  (cont.)  

Before  Departure   Date  Complete  

For  any  collaborating  institution  on  an  award  with  subcontracts,  notify  the  collaborating  institution  in  writing  that  the  award  will  be  transferring.  If  you  have  a  Certificate  of  Confidentiality,  notify  the  issuing  office  of  your  new  institutional  affiliation.  

Financial  Responsibilities:  With  the  help  of  the  appropriate  administrator,  prepare  budget  for  remaining  months  at  the  University  and  ensure  the  correct  amounts  of  funds  are  left  at  the  University  to  cover  any  outstanding  balances.  Request  that  your  administrator  (department  or  school  as  appropriate)  prepare  a  relinquishing  statement  or  similar  sponsor  document.  Your  administrator  will  work  with  OSP  and  the  school  for  final  approval.  Review  and  certify  final  expenditures  made  to  grant  or  contract.  

Resolve  any  outstanding  commitments  and  budget  deficits.  

Contact  the  OSP  effort  reporting  coordinator  (4-­‐3852)  to  make  arrangements  to  review  and  certify  final  effort  reports  for  you  and  your  lab  personnel.    

Material  Transfer  Agreements  (MTA):  Coordinate  with  contracting  staff  in  OSP  to  ensure  proper  closeout  of  existing  material  transfer  agreements  and  confidential  disclosure  agreements.  Review  terms  of  MTA  and  ensure  materials  are  handled  accordingly.  Materials  to  be  transferred  to  another  institution  will  likely  require  a  new  MTA  to  be  processed  between  the  providing  entity  and  the  receiving  entity.  Before  materials  are  transferred  permission  must  be  granted  by  the  provider.  

Confidentiality  Agreements:  Coordinate  with  contracting  staff  in  OSP  to  ensure  proper  closeout  of  existing  confidential  disclosure  agreements.  Review  terms  of  confidentiality  agreement  to  ensure  that  any  information  provided  is  handled  accordingly.  Information  to  be  transferred  to  another  institution  will  likely  require  a  new  MTA  to  be  processed  between  the  providing  entity  and  the  receiving  entity.    

Research  Contracts:    Coordinate  with  contracting  staff  in  OSP  to  ensure  proper  closeout  of  contracts.  

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Faculty  Departure  Checklist,  August  2015      p.  10  

APPENDIX  B:  RESEARCH  LAB  /  HAZARDOUS  MATERIALS  To  be  completed  by  an  investigator  responsible  for  closing  down  a  laboratory.  

When  vacating  laboratories  containing  potentially  hazardous  materials  (chemical,  biological,  radiological,  sharps,  or  other  hazards),  it  is  imperative  that  principal  investigators  coordinate  with  the  Office  of  Environmental  Health  and  Safety  (EHS)  to  ensure  proper  disposal  or  transfer.  Failure  to  comply  with  the  rules  that  govern  hazardous  materials  is  significant  and  could  result  in  civil  or  criminal  penalties,  including  monetary  fines  and  imprisonment.  

Office  of  Environmental  Health  and  Safety  (EHS)    982-4911  http://ehs.virginia.edu/ehs  

30–60  Days  from  Departure  Date   Date  Complete  

Notify  your  unit  administrator  or  school  administrator  and  EHS  of  your  intent  to  close  down  a  research  laboratory  to  ensure  that  you  have  adequate  time  for  appropriate  decontamination,  transfer,  surplus,  or    disposal  of  any  hazardous  materials  and  equipment.  Refer  to  EHS  checklists  for  instructions  and  schedule  a  meeting  with  EHS:  http://ehs.virginia.edu/ehs/ehs.lab.decommission.html  

Before  Departure   Date  Complete  

Decontaminate  all  hazard-­‐containing  or  hazard-­‐labeled  equipment  before  transfer,  surplus,  or  disposal,  in  accordance  with  EHS  instructions.  

Dispose  of  unwanted  hazardous  materials  in  accordance  with  EHS  waste  procedures.  Contact  EHS  as  early  as  possible  to  make  arrangements  for  removal;  significant  lead  time  is  often  required.    

If  you  are  a  generator  of  hazardous  waste,  contact  EHS  to  verify  the  disposal  of  your  wastes  and  confirm  proper  labeling  of  all  hazardous  materials  that  will  not  be  disposed.  

Consult  with  EHS  on  the  proper  transport  or  shipping  of  hazardous  materials  or  equipment  if  you  plan  to  transfer  hazardous  materials/equipment  to  another  institution  or  foreign  entity.  

Post-­‐Departure   Date  Complete  

Department  administrator  coordinates  with  EHS  for  final  walkthrough  of  vacated  space(s)  and  signs  the  EHS  “Green  Sign,”  which  is  to  be  posted  on  the  door(s)  acknowledging  all  hazardous  material  has  been  removed.  

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Faculty  Departure  Checklist,  August  2015      p.  11  

APPENDIX  C:  HUMAN  SUBJECT  RESEARCH  To  be  completed  by  an  investigator  working  on  a  human  subject  research  protocol.  

It   is   imperative   that  proper  steps  be   taken  with   regard  to   the  disposition  of  human  subject   research  protocols  prior   to  departure  from  the  University.  All  items  listed  below  should  be  completed  PRIOR  to  the  faculty  member’s  departure  from  UVA.  

IRB-­‐HSR  (Institutional  Review  Board  for  Health  Sciences  Research)  924-­‐9634  or  243-­‐9847  http://www.virginia.edu/vpr/irb/hsr/  

IRB-­‐SBS  (Institutional  Review  Board  for  Social  and  Behavioral  Sciences)  924-­‐5999  http://www.virginia.edu/vpr/irb/sbs/  

60-­‐90  Days  from  Departure  Date   Date  Complete  

Contact  the  appropriate  IRB  overseeing  protocols/  grants  to  identify  open  protocols/grants  and  provide  IRB  with  departure  date  

PROJECTS  TO  BE  TRANSFERRED:   Date  Complete  

Assess  transferability  of  research  to  new  institution  (e.g.,  geographic  proximity  for  human  subjects,  etc.)  

Submit  application  through  new  institution’s  IRB.  

Submit  management  plan  for  any  currently  enrolled  research  subjects  (e.g.,  withdrawing  subjects  from  research  who  do  not  wish  to  be  transferred  to  the  new  institution,  etc.)  to  UVA  IRB  with  closure  form.  

Consult  with  IRB-­‐HSR  if  you  will  be  transferring  specimens  or  health  information  from  subjects.  Please  note  that  the  IND  and  the  Certificate  of  Confidentiality,  if  applicable,  transfer  with  the  protocol.  

Submit  closure  form:  IRB-­‐HSR:    

Protocols:  http://www.virginia.edu/vpr/irb/HSR_docs/Forms/Closure_Form-­‐Protocols.doc  Grants:  http://www.virginia.edu/vpr/irb/HSR_docs/Forms/Closure%20Form-­‐Grants.doc  

IRB-­‐SBS:  http://www.virginia.edu/vpr/irb/sbs/forms.html  

PROJECTS  TO  BE  RETAINED  AT  UVA   Date  Complete  

If  you  will  remain  the  PI  on  the  project,  ask  department  chair  to  initiate  process  with  school  and  Office  of  Vice  President  of  Research  to  approve  your  continued  PI  status.  See  Procedure  8-­‐8,  Office  of  Sponsored  Programs.  

If  a  new  PI  will  be  appointed  at  UVA,  work  with  department  to  identify  new  PI.  When  research  is  industry-­‐sponsored,  the  sponsor  has  final  approval  over  change  of  PI  and/or  change  of  institution  and  modification  of  any  clinical  trial  agreements.  Ask  department  to  contact  OSP  to  discuss  details.  

http://www.virginia.edu/vpr/irb/hsr/  IRB-­‐SBS  (Institutional  Review  Board  for  Social  and  Behavioral  Sciences)  924-­‐5999  

http://www.virginia.edu/vpr/irb/sbs/  

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Faculty  Departure  Checklist,  August  2015      p.  12  

Appendix  C:  Human  Subject  Research  (cont.)  

PROJECTS  TO  BE  RETAINED  AT  UVA  (Continued)   Date  Complete  

IRB-­‐HSR:  

Complete  IRB-­‐HSR  Personnel  Change  Form.  

Modify  IRB-­‐HSR  protocol/applicationprincipal  investigator.  

 using  tracked  changes  and  obtain  signatures  from  new  

ModifySubmit  to  IRB-­‐HSR.  

 IRB-­‐HSR  consent  form  using  tracked  changes,  if  protocol  remains  open  to  enrollment.  

IRB-­‐SBS:  

Complete  and  submit  IRB-­‐SBS  modification  form.  

Modify  IRB-­‐SBS  protocol  and  obtain  signatures  obtained  from  new  principal  investigator.  

Obtain  signature  of  new  principal  investigator  on  investigators  agreement.  

Modify  PI  information  on  all  IRB-­‐SBS  consent  materials  if  protocol  remains  open  to  enrollment.  

Submit  all  documents  to  IRB-­‐SBS  as  instructed.  (All  forms  may  be  found  at  http://www.virginia.edu/vpr/irb/sbs/forms.html)  

PROJECTS  TO  BE  TERMINATED   Date  Complete  

Submit  closure  form:  IRB-­‐HSR:    

Protocols:    http://www.virginia.edu/vpr/irb/HSR_docs/Forms/Closure_Form-Protocols.doc  Grants:  http://www.virginia.edu/vpr/irb/HSR_docs/Forms/Closure%20Form-­‐Grants.doc  

IRB-­‐SBS:  http://www.virginia.edu/vpr/irb/sbs/forms.html  

If  biomedical  research,  consult  with  School  of  Medicine  Clinical  Trials  Office  to  archive  data.  

If  biomedical  research,  consult  with  UVA  Records  Management  Office  regarding  records  disposal.  

Consult  with  IRB-­‐HSR  if  you  will  be  transferring  specimens  or  health  information  from  subjects.  Please  note  that  the  IND  and  the  Certificate  of  Confidentiality,  if  applicable,  transfer  with  the  protocol.  

RETENTION  OF  CLINICAL  TRIALS  DATA   Date  Complete  

Describe  data  generated  during  clinical  trial  for  which  you  were  the  principal  investigator  that  must  be  retained  under  contractual  obligations  or  FDA  regulations.  Include  the  following:  where  the  data  are  stored;  number  of  boxes/file  cabinets  involved  and  how  they  are  identified;  how  long  the  records  must  be  retained;  sponsor  contact(s);  and,  if  stored  at  a  secure,  commercial  facility,  the  source  of  future  storage  costs  through  destruction  of  the  records.  For  assistance,  contact  the  Clinical  Trials  Office.  

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Faculty  Departure  Checklist,  August  2015      p.  13  

Appendix  C:  Human  Subject  Research  (cont.)  

SECTION  II:    Sub-­‐Investigator  must  complete  Section  II  for  each  protocol  on  which  they  are  listed.Date  

Complete  

If  you  will  continue  to  work  on  the  protocol  after  you  leave  UVA,  notify  the  principal  investigator  and  IRB.  

Modify  protocol  using  tracked  changes  and  submit  to  IRB.  

Sign  an  unaffiliated  investigators  agreement  and  submit  to  IRB  with  modified  protocol.  

Request  that  PI  contact  Grants  and  Contracts  Office  to  determine  if  a  contract  will  be  required.  

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Faculty  Departure  Checklist,  August  2015      p.  14  

APPENDIX  D:  ANIMAL  RESEARCH  To  be  completed  by  an  investigator  using  animals  as  research  subjects.  

It  is  imperative  that  proper  steps  be  taken  with  regard  to  the  disposition  of  animal  subjects  prior  to  departure  from  the  University.  All   items   listed  below   should  be   completed  PRIOR   to   the   faculty  member’s   departure   from  UVA.   Failure   to  adhere  to  these  procedures  will  result  in  the  following:  

1. A   letter  of   reprimand  will  be  sent   to   the  principal   investigator;  with  a  copy  sent   to   thedepartment  chair  and  to  the  IACUC  at  the  new  institution.  

2. Any   expenses,   including   per   diems,   will   be   billed   to   the   faculty  member’s   departmentchair  for  the  recovery  of  costs  incurred.  

3. Euthanasia  of  animals  may  be  conducted  at  the  discretion  of  the  IACUC.

Institutional  Animal  Care  and  Use  Committee  (IACUC)  924-­‐0405  http://www.virginia.edu/vpr/iacuc  

Center  for  Comparative  Medicine  924-­‐2741  

Date  At  Least  90  Days  Before  Departure  Date   Complete  Send  written  notification  to  the  Institutional  Animal  Care  and  Use  Committee  (IACUC)  Office  and  the  Center  for  Comparative  Medicine  informing  them  of  your  intent  to  leave  the  University.  The  notification  must  include:  exact  date  of  departure,  requested  date  of  protocol  termination,  intended  disposition  of  any  remaining  animals,  and  new  contact  information.  The  IACUS  policy  on  departing  faculty  must  be  followed:  https://researchcompliance.web.virginia.edu/acuc/pi/policy/Policy_Departing_Faculty.pdf.      

If  you  intend  to  transfer  any  animals  remaining  in  inventory  to  another  investigator’s  protocol  or  have  the  animals  transferred  to  the  new  institution,  you  must  contact  the  director  of  the  Center  for  Comparative  Medicine  to  obtain  approval  and  to  complete  the  appropriate  transfer  forms.  (Dr.  Sanford  Feldman:  4-­‐5058  or  [email protected])  Note:  Animals  transferring  to  another  institution  will  likely  need  to  be  placed  in  quarantine  at  the  new  institution,  so  adequate  lead-­‐time  must  be  taken  into  account.  Weather  may  also  determine  acceptable  shipping  time  for  animals.  

If  you  plan  to  continue  collaborative  research  with  another  qualified  UVA  faculty  member,  the  collaborating  UVA  faculty  member  must  agree  to  accept  responsibility  for  any  ongoing  research  and  animals  in  inventory.  The  departing  faculty  member’s  protocol  will  be  terminated;  therefore,  the  collaborator  must  submit  a  NEW  animal  use  protocol  under  his/her  name  to  the  IACUC  Office  together  with  a  cover  letter  that  clearly  details:  

• the  nature  of  the  collaborative  work,• the  collaborator’s  willingness  to  accept  the  research  project  and  the  extent  of  his/her

experience  with  the  research  of  the  departing  investigator,• any  graduate  students  or  post-­‐docs  previously  supervised  by  the  departing  faculty  member

who  will  continue  to  work  on  their  projects,  and• the  timetable  for  completion  of  the  collaborative  project.

Data  associated  with  animal  subjects  must  be  retained  in  accordance  with  the  IACUC  data  retention  policy:  https://researchcompliance.web.virginia.edu/acuc/pi/policy/Policy_Document_Retention_for_Investigators.pdf  

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Faculty  Departure  Checklist,  August  2015      p.  15  

APPENDIX  E:  TRANSFER  OF  EQUIPMENT,  DATA,  RECORDS,  OR  OTHER  ITEMS  To  be  completed  by  a  faculty  member  intending  to  transfer  materials  to  another  institution.  

In  many  cases,  faculty  members  will  have  equipment,  data,  records,  or  such  things  as  specimens,  cell   lines,  or  reagents  that  they  would  like  to  take  with  them  when  they  leave  the  University.  The  ownership  of  these  items  may  be  unclear.  It  is  best   to   clarify   these   issues   prior   to   your   departure   or   the   transfer   of   these   items.   All   items   listed   below   should   be  completed  PRIOR  to  the  faculty  member’s  departure  from  UVA.  

Office  of  the  Vice  President  for  Research      924-3606  or  924-7026  Fixed  Assets  Accounting  

http://www.virginia.edu/finance/finanalysis/prop.html  

60-­‐  90  Days  Before  Departure  Date   Date  Complete  

Faculty  moving  to  another  university  who  want  to  transfer  research  equipment  with  them  must  have  approval  from  the  department  head  and  dean  and  notify  the  Fixed  Assets  Accounting  Group  of  the  Department  of  Financial  Analysis  &  Reporting.  Restrictions  on  such  a  transfer  depend  on  who  has  titlethe  equipment.    

 to  

see  also:  Preparation    of  Inventory  Change  Request

Fixed  Assets  –  Releasing  UVA  Capital  Equipment  to  Another  Institution  Outside  the  Commonwealth  

Equipment  Inventory  Change  Request  (P-­‐1)  Form  

Data  or  Records  If  you  will  be  transferring  data  Recordkeeping,  which  applies  to  all  research  data  or  records  even  if  they  were  not  collected  in  a  "lab.”  

or  records,  please  see  policy  RES-­‐002:  Laboratory  Notebook  and  

Equipment  If  you  will  be  transferring  equipment,  please  see  policy  X.A.2:  Fixed  Assets—ReleasingEquipment  to  Another  Institution  Outside  the  Commonwealth    

 UVA  Capital  

Other  Items  If  you  will  be  transferring  items  such  as  specimens,information  on  Material  Transfer  Agreements.    

 cell  lines,  or  reagents,  please  see  the  additional  

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Faculty  Departure  Checklist,  August  2015      p.  16  

APPENDIX  F:  INTELLECTUAL  PROPERTY  To  be  completed  by  a  faculty  member  who  has  patent  or  invention  activity.  

It   is   important   to   communicate   with   the   Licensing   &   Ventures   Group   regarding   any   potential   issues   that   may   arise  related  to  the  faculty  member’s  intellectual  property  portfolio.  All  items  listed  below  should  be  completed  PRIOR  to  the  faculty  member’s  departure  from  UVA.  

Licensing  &  Ventures  Group    924-­‐2175  

Before  Departure   Date  Complete  

Disclose  final  update  and  data  related  to  any  previously  disclosed  inventions.  

Disclose  any  final  inventions  (including  any  inventions  disclosed  in  invention  statements  on  Page  9).  

Provide  new  address  and  contact  information  for  on-­‐going  activitiesprosecutions,  licensing  support,  revenue  distribution,  etc.)  

 correspondence  (patent  

Provide  point  of  contact  at  technology  licensing  office  @  new  institution  (if  applicable).  

Ensure  all  necessary  documentation  (inventionexecuted  and,  if  applicable,  notarized.  

 disclosures,  patent  assignments,  etc.)  have  been  

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Faculty  Departure  Checklist,  August  2015      p.  17  

APPENDIX  G:  PATIENT  CARE  To  be  completed  by  a  faculty  member  who  is  involved  with  patient  care.  

It  is  important  that  the  faculty  member  communicate  with  his/her  patients  and  make  arrangements  for  their  continued  care.  All  items  listed  below  should  be  completed  PRIOR  to  the  faculty  member’s  departure  from  UVA.  

Piedmont  Liability  Trust      296-­‐2100  UVA  Health  Information  Services      243-­‐5811  

90  Days  From  Departure  Date   Date  Complete  

Notify  your  patientsappropriate.  

 of  your  departure  and  make  arrangements  for  the  transfer  of  their  care,  as  

Notify  Piedmont  Liability  Trust  of  your  departure  date.  

Discuss  with  youryou  leave  UVA.  

 department  chair  how  income  from  your  patient  billing  accounts  will  be  handled  after  

Approximately  14  Days  From  Departure  Date   Date  Complete  

Contact  Health  Information  Services  for  assistance  regarding  the  appropriate  storage  of  privately  held  patient  charts.  

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Faculty  Departure  Checklist,  August  2015      p.  18  

APPENDIX  H:  EXPORTS  AND  TECHNOLOGY  CONTROL  PLANS  To  be  completed  by  a  faculty  member  who  is  participating  in  export  controlled  activity.  

It   is   important   that   the   faculty  member  communicate  with   the  Office  of  Export  Controls   regarding   involvement   in  any  activity  subject  to  a  technology  control  plan.  All  items  listed  below  should  be  completed  PRIOR  to  the  faculty  member’s  departure  from  UVA.  

Export  Controls    982-­‐1539  

60-­‐90  Days  From  Departure  Date   Date  Complete  

Contact  the  Office  of  Export  Controls  by  email  (export-­‐[email protected])  for  help  in  determining  how  to  transfer  your  responsibilities  related  to  export  controlled  projects  to  others  or  to  establish  a  plan  for  your  continuing  involvement  with  the  project.  

Contact  your  new  employer’s  office  or  person  responsible  for  export  controls  and  put  them  in  touch  with  the  UVA  Office  of  Export  Controls  to  coordinate  the  transfer  of  any  export  controlled  technical  data,  equipment,  software  or  other  materials.  

If  you  will  be  working  in  a  foreign  country  or  for  a  foreign  entity  (company,  institution,  government,  individual,  etc.)  and  plan  to  continue  your  involvement  with  an  export  controlled  project  after  leaving  UVA  work  with  the  Office  of  Export  Controls  to  apply  for  any  necessary  export  licenses  or  other  authorizations  prior  to  your  departure.  The  Office  of  Export  Controls  cannot  guarantee  that  all  destinations  will  be  eligible,  willing  or  able  to  accept  export  controlled  materials  or  that  the  U.S.  government  will  approve  any  license  applications.  

Within  the  Last  Few  Days  of  Departure  Date  (or  prior  to  packing  and  shipping)  

Date  Complete

Contact  the  Office  of  Export  Controls  by  email  (export-­‐[email protected])  to  confirm  authorization  to  remove  export  controlled  technical  data,  equipment,  software  or  other  materials  from  UVA.  Items  subject  to  a  pending  or  denied  export  license  application  may  not  be  exported  by  or  from  UVA.  

Notify  the  shipper  or  freight  forwarder  if  export  controlled  technical  data,  equipment,  software  or  other  materials  will  be  included  in  any  shipment  from  UVA  to  a  foreign  destination  and  ensure  that  they  receive  copies  of  all  export  licenses  or  other  authorizations  and  make  appropriate  submissions  through  AESDirect;  the  Office  of  Export  Controls  can  work  with  the  shipper  or  freight  forwarder  to  facilitate  this  process.